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Institutions and PTSD

June 25, 2008

Last week, I ran across an excellent piece I hadn’t noticed before, at autistics.org: Conversation on Institutions. A warning to anyone with experience of institutional conditions: it is likely to be highly triggering. I found it so in a mostly good way, though to the point that I can only write about it now. I worked on this post over the weekend, but finally got back to it tonight, after I found a Monk episode we were watching on DVD triggering enough that I had to leave the room. I’m still shaking some, and my heart and stomach haven’t completely settled down a few hours later. The flashbacks hit me harder than I’d have expected.

Mostly I started working on this again because the topic was on my mind, but I must admit that it was also partly out of a desire to help DH understand why my behavior got so weird so quickly in response to a pleasant before-bed DVD. I’m not sure that anyone who hasn’t had similar experiences will be able to understand, though.

I have enjoyed Amanda’s treatment of institutions and their inherent awfulness before, over at Ballastexistenz. Looking again, I must have skimmed over her Outposts In Our Heads post before, because it was just too uncomfortable. (I felt like I was going to have a heart attack reading it just now, and I’m fairly used to anxiety symptoms by now.) The conversation/interview piece linked to above really hit the right spot for me at the moment, though, and brought home just how much lasting difficulty I’ve had from my dealings with abusive institutions.

Besides being trapped in a very abusive school system for ten years, I was stuck in psychiatric hospitals three times in as many years after I hit adolescence (and all the stress started taking its toll). A while back, I went into those experiences in another post. This piece helped me recognize that the two experiences weren’t separate, but each reinforced the same PTSD-inducing institutional mentality–and left me more vulnerable to psychological harm from the other. Nor did it qualify as “nothing,” having spent all day, five days a week immersed in a particularly racist version of Lord of the Flies. Like Spenser in (Robert B. Parker’s) School Days, I’m just surprised that Columbine-style incidents don’t happen more frequently.

One point that Laura Tisoncik hit on repeatedly in the interview/article helped snap me out of the “oh, but I don’t really have anything to complain about–nobody was beating me or anything” trip:

And I’m really quite certain that there’s kind of a floor in human experience, where you can’t get much worse, you can’t get any worse. Because after a certain point, you just sort of turn off and walk through it like it’s a dream, and you can’t actually be hurt any worse than that. Yes, you can be physically damaged worse than that, but the basic core experience after you reach that particular point of hellish, remains pretty much standard. . .
But the worst thing about those places is not those bad things. It’s the day-in, day-out, every moment of the day degradation and lack of control of your life.

I knew precisely what she was talking about, and have to agree. Nobody physically restrained and/or beat me, but they didn’t need to. Having been hit too, I can say that the emotional abuse does more severe and lasting damage. And, as Amanda put it in her “Outposts” post: “If you are beaten, you know you are being beaten. Mental and emotional abuse — intentional or unintentional — can be strong and subtle at once.”

Now I am reaching the point that I am able to look at what happened, and recognize it for just that: a cold, systematic attempt to tear my mind and soul apart. I knew things weren’t right at the time, but I needed a lot of recovery time to see how bad they actually were. Knowing how weird power games and institutions fit together has helped with that, too. I was more likely to blame myself when I had no idea what kind of unfortunate motivations the people mistreating me might have.

Reading this article, I was nodding as I went along, and Laura and Amanda may as well have been describing my experiences–until I got a little more than a third of the way through. Yeah, the environment they describe is toxic to any thinking, feeling being; I could already see that, but the validation that I wasn’t just being crazy just seeing it felt great. Then I read (and reread, and…) Laura’s description of the typical psych survivor–really “abusive institution of any sort” survivor–PTSD pattern of behavior she’d spotted in Amanda, straight away.

That provided the humongous shock for me; again, she could have been talking about me at a certain time, and a lot of it still lingers like the smell of rotting fish. I still get terrified that people will jump on me over anything that can be construed as an error, people have gotten angry at me over the endless apologies that really mean “you’re acting upset, please don’t hurt me”, and so on. I have been ridiculed or had people become angry when I responded in ways (like with the apologies, and overt guilt) that I’d been trained to respond. At least I’m rarely afraid of having “wrong” thoughts anymore. Reading this section of the conversation, I was finally able to see just where a lot of my ostensibly crazy and annoying behavior has been coming from.

I’m in my thirties now, and I still have serious trouble with initiative, and keep trying to suss out the rules–and panicking when I can’t find them. That has helped me stay under/unemployed, as has my (well-founded) fear of going back to any kind of school. The combination of my only recently recognized auditory processing issues and being immersed in a very different dialect–so that I have trouble figuring out what people might be saying from context or lipreading, too–has been bringing on flashbacks to elementary school, when I couldn’t understand probably 75% of what was being said in class. You can probably imagine what kind of treatment that led to, and I keep expecting to get it again.

I see now that the PTSD is also behind my medical “phobia”, and my needing an interpreter to have any hope of getting listened to by most doctors; too many of them feel a need to play horribly familiar power games, and I shut right down in response. (And continue to blame myself for “not handling things properly” and “not trying hard enough”.) That particular difficulty is on my mind now, since I have been avoiding seeing the GP and trying to get across that the diabetes medication is making me sick. The stress from being sick isn’t helping me get functioning at a level where talking to the doctor, much less not allowing myself to be bulldozed, is even vaguely possible. At least I have a decent idea why this might be, now, and it’s not just my being “difficult” or “lazy”.

I have been blaming a lot of these things on being autistic, since I figured that one out, but this is looking more and more like another case of the lasting effects of ill treatment being attributed to autism itself. Seeing some feelings and behaviors directly attributed to PTSD, in a way that makes complete sense, really made me think about this. It seems much more likely that being autistic has made me stand out as a target, and possibly made me more vulnerable to some of the aspects of the PTSD.

I have been rereading Marie-France Hirigoyen’s Stalking The Soul, on emotional abuse. Originally, I picked it up after becoming more aware of some emotional abuse from individuals, but a lot of it applies well to institutional abuse, not just the sections on abuse in the workplace. On both readings, I have found her discussion of how the targets are systematically broken down, and rendered unable to stop the abuse–only to feel guilty over not resisting effectively, and somehow responsible for the entire situation–very helpful. She also addresses a common process nicely, in which the abuser makes the target crazy, and then tries to discredit them because they’re responding sensibly under the circumstances. This is frequently a factor in the Pulling the Cat’s Tail effect. I’ve been on the wrong end of that tactic, too many times to count, and initially got hospitalized over a “tail pulling” meltdown episode.

In a psychiatric or psychological context, actual hospitalization did not do the worst harm; being forced into therapy did. As Laura put it:

Psychotherapy messes with the brain. It basically tells you up is down and right is left and whatever. And especially when one is experiencing that level of badness, one is very vulnerable. I mean it is precisely the kind of thing that people who try to brainwash other people, the kind of environment they try to generate, because at that point people are very vulnerable, and you’re more likely to get them to do anything. I think it’s not accidental that what’s been happening to prisoners in Iraq, the things that they were doing to break down the prisoners, it makes a lot of sense. Terrorize people and humiliate them and make them feel as vulnerable as possible, and in fact people do tend to become emotionally and mentally vulnerable as well.

And so psychotherapy in that context can really mess one up. I mean all it takes is a therapist who thinks they know everything about you, they know all about your life, they know what you’re thinking, they know what you should think, they know what you’re experiencing, et cetera, et cetera, et cetera. And they tell you about what they know, and they tell you what you should know. Whether or not it has anything to do with reality.

My parents forced me to continue in outpatient therapy for years, under threat of going straight back to the hospital. That threat constantly hanging over my head made the whole thing more damaging; I’d have done, or said, about anything to avoid going back into that situation. The longer I got to hear what I must be feeling, why I must be feeling that way, what my motivations must be, etc., the more I needed some real help. I’d already experienced a lot of skewed assumptions about my motivations and feelings, from people who didn’t even try to understand (and they say we’re the ones with poor Theory of Mind!), mostly by control freaks who were projecting for all they were worth. That left me even more vulnerable to getting my mental processes jerked around, and doubting myself. Even the professionals who truly did seem to want to help people kept insisting that my thoughts and basic way of thinking must fit their narrow mold, no matter what the reality was–and I must be deluding myself if I said otherwise. Everything I said and did was pathologized, to the point of assumed psychosis a couple of times. I am not very good at lying, but I resorted to completely fabricating what I had been up to, and what my concerns were, to fit what they were willing to hear–and I must have judged the audience well, because they actually believed what I invented. When I let my guard down and admitted to being bullied, that got turned around on me, and I got stuck in a social skills group.

I kept hearing basically the same faulty interpretations, and couldn’t help but start wondering if they might be right. I started feeling crazy, and doubted pretty much every perception and reaction I had. I did not have suicidal thoughts before people started twisting my brain around, with obvious conflicts of interest; by now they’re programmed in as a sign that I really need to get some needs taken care of, pronto, so that the depression and PTSD might quiet down to the point that I’m not in danger. The thoughts themselves reek of somebody else’s scripting. I also get thrown for a real loop, moodwise, more easily in the first place (due in part to years of neurotransmitter tampering, no doubt).

This went on for years, and all the medications didn’t help one bit. I was coerced into taking them at first, as well, and was either considered to be “acting out” when I reported some pretty hideous side effects, or they were considered worth it to “fix” me. I obviously just didn’t want to get better, and Wasn’t Trying Hard Enough. Losing insurance coverage improved matters, since there went the therapy; even my mother, who watched me get to the point I rarely left the house for several years, drew the line at the local sliding scale services, once she saw their general level of quality. At least I wasn’t getting as much external reinforcement that I must be bonkers anymore. It’s just been a couple of years now since I stopped seeing psychiatrists, and stopped taking meds I didn’t need. Finding out that I was probably autistic, and reacting to bad situations (as described in a recent post) gave me a firmer foothold to question the situation more. Trying to unscramble my brains hasn’t been easy at all. I am trying to allow myself the consideration and basic kindness I would show to anyone else on this Earth, and believing that I deserve it isn’t easy either.

Amanda offers another description that’s eerily close to what I’ve experienced in her “Why It’s So Hard to Write Directly About My Life”. Her writings have made me feel less crazy overall, seeing someone else who’s gone through similar things.

After all this time, I am feeling guilty for wasting people’s time with a long post, and questioning my writing skills because I can’t condense it much. I am feeling anxious about possibly blowing things completely out of proportion, and making a big deal out of nothing because I overreact to everything, and sound paranoid sometimes. (How many of this type of internalized put-down can you string into one sentence?) I still don’t expect to be believed when I call what happened to me abuse. I am concerned about coming across as a whiny, selfish pain in the ass, who expects life to be easy. Even though I realize it’s ridiculous, I am wary of someone jumping on me because they don’t like something I’ve said or the way I’ve said it. At the same time, I am afraid that what I have to say is not important enough for anyone else to read at all. At the back of my mind, I’m considering the possibility that just being up in the wee hours (in front of the computer, no less) is a sign that something is Wrong With Me.

This is actually way better than it used to be. Is it a wonder that it takes me ages to get things done sometimes, or that my general functioning level isn’t what it “should” be? I’m not wallowing in self-pity here, nor resigning myself to an unreasonably low level of “functioning”/quality of life; I have broken through into overdue outrage. It makes me very angry the way people get manipulated, and then have further nasty assumptions thrown onto the pile when they show some after-effects. I’m past tired of responding with trained self blame.

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